title: Immunosuppression effects on airway mucociliary clearance: comparison between two triple therapies.
abstract: BACKGROUND
  Tacrolimus and mycophenolate have now become the most widely used combination for maintenance immunosuppressive regimens after lung transplantation in comparison with cyclosporine and azathioprine. However, limited information is available with respect to their effects on cells, other than those from the immunologic compartment. We hypothesized that different triple therapies could have different effects on airway mucociliary clearance, playing an important role in respiratory infections observed after lung transplantation.
  
  
  METHODS
  Ninety rats were assigned to three groups (n = 30 each): control = vehicle, therapy 1 = tacrolimus + mycophenolate + prednisone, and therapy 2 = cyclosporine + azathioprine + prednisone. After 7, 15, or 30 days of treatment by gavage, the animals were killed and the following parameters were studied: mucus transportability, ciliary beating frequency, mucociliary transport velocity, and neutral and acid mucus production.
  
  
  RESULTS
  There was a significant decrease in ciliary beating frequency, mucociliary transport velocity, and neutral mucus production in all immunosuppressed animals; indeed, both therapies, mainly therapy 1, caused an increase in acid mucus production for as long as 15 days of treatment.
  
  
  CONCLUSIONS
  Both triple therapies impaired airway mucociliary clearance of rats, but therapy 1 had a more deleterious effect. These data suggest that these undesirable effects can contribute to the high incidence of respiratory infections observed in patients undergoing lung transplantation.
authors.affiliation: Laboratory of Thoracic Surgery Research-LIM61, Department of Cardiopneumology, Heart Institute (InCor), Hospital das Clinicas, São Paulo, Brazil.
authors.forename: Maristela
authors.initials: M
authors.lastname: Prado e Silva
authors.forename: Sônia F
authors.initials: SF
authors.lastname: Soto
authors.forename: Francine M
authors.initials: FM
authors.lastname: Almeida
authors.forename: Tatiana T K
authors.initials: TT
authors.lastname: Limonete
authors.forename: Edwin R C
authors.initials: ER
authors.lastname: Parra
authors.forename: Fabio B
authors.initials: FB
authors.lastname: Jatene
authors.forename: Paulo M
authors.initials: PM
authors.lastname: Pêgo-Fernandes
authors.forename: Rogerio
authors.initials: R
authors.lastname: Pazetti
mesh_terms: D000818:Animals; D004359:Drug Therapy, Combination; D007165:Immunosuppression Therapy / Q000009:adverse effects*; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D008297:Male; D009079:Mucociliary Clearance / Q000187:drug effects*; D051381:Rats; D017208:Rats, Wistar
chemical_list: D007166:Immunosuppressive Agents
keywords: 12